A systemic analysis of “Health Care Management of Today” would fill a book which is not possible for giving just background information.
1.1 “Health Management” Instead of “Disease Management”
Some 3000 years ago, in China, “Health Management” was literally “health-oriented”. It was therefore comprehensive and integrative and therefore necessarily preventive: The ancient Chinese “Health Care Professionals” (HCP's) were rewarded for the health of their “clients” (unlike the Latin origin word “patient”, literally translated “suffering ones”) and not for treating diseases.
On the contrary, today's health care systems can be defined as “health reparation” systems or “disease management” systems for which it is a common saying in the American Medical Community that there are “rushed doctors” working “in a fragmented system”.
1.2 Alienation from Individual Health Management: The Fragmented Health Care System
It seems that the citizens of the First World countries in the so-called “Trias” (North America with USA, Canada; Europe; Japan plus ASEAN) are “separated” from their health to use a strong term.
Especially in the United States of America, the pharmaceutical companies and the “payors”, the insurance companies, are more or less in one hand. Thus, the doctor working in an HMO is very much in a situation of an “economically dependent” person (and economic “victim”) with the patient so to say being the “victim of the victim”.
The United States of America make up 4% of the First World population. They spend 40% (factor 10 !) for “disease management” with very poor results: 66% of the population are overweight, 34% are “obese”, and the rate of diabetics type 2 (which is a result of the “individual health management” of the persons concerned) is by far the highest in all First World countries. This situation has been described by Prof. Dr. Paul Ciechanowski, a leading US expert for Diabetes Management, Depression Management, “Diapression” (“An Integrated Model for Understanding the Experience of Individuals With Co-Occurring Diabetes and Depression”, 2011): “the rushed doctor in a fragmented system”.
Therefore, a comprehensive and integrative person/patient-centered “health care” model is needed. Health education is not dealt with in elementary, secondary or high schools—nor in colleges or at universities. Although it is the most valuable good of mankind, it is not treated and protected as such.
1.3 Role Concepts of Patients and Doctors in the Western World of Today (Examples USA and Germany/Europe)
An analysis of the role concepts of “patients” and doctors/HCP's.
The research in Europe (in Germany) which also reflects results in the USA and Japan (although the frequency in the groups is certainly different in these countries and the social background influences the results so that in each country a specific analysis is needed) is described in the following in order to give some basic insight.
The following pattern of patients exist:                Group 1 “DETERMINISTIC GROUP”: “Health is determined by fate (good or back luck).”        Group 2 “MEDICAL” BELIEVER GROUP”: “I cannot do anything. My (high quality) doctor is in charge of my health.”        Group 3 “NATURE GROUP”: “Avoid the doctor and the medical institutions. Live healthy—and everything will be fine.”        Group 4 “ENLIGHTENED COLLABORATIVE CARE GROUP”: “I am aware of the fact that it is my health and my life: So I am looking for a doctor/HCP as a professional partner and act as a more or less self-conscious and responsible partner of my doctor and/or the health care professionals.”        
The doctors have corresponding role concepts:                Authoritarian doctors like the deterministic group patients. These patients listen to the doctor as if he was “fate” or even “God”.        The paternalistic doctors prefer the medical believer group. They are seen as an authority and the patients cling to their lips.        
All groups of doctors are somewhat distant and skeptical about the nature group which avoids contact with the doctors and is more of an “anti business model”. The “enlightened collaborative care group” is officially preferred by all doctors. But one thing is what is said in theory (“We all like and strive for ‘collaborative care’”)—the reality may be far away from it. According to several research results, 80% of the patients in the USA receive about 20% of the health care visit time of the American doctors. The other 20%, the “system-preferred” receive 80% of the health care visit time.
1.4 Standardized Medical Treatment
It is evident and need not be proved that first of all, standardized medical care is necessary for all patients to create a basis (“basic service”).
1.5 the Patient as an “Object” Vs. The Responsible “Empowered” Self-Conscious Patient
Again, there is no need to argue that the patient as an object certainly receives the minimum care and has good chances to survive.
For an optimum life span, for best quality of life, and for a best medical treatment in the case of illness, however, clearly the “empowered” patient, showing initiative, empowerment and being able to carry out a “high quality self-care” has the better life.
1.6 Openness, Trust, and a Positive Doctor-Patient Relationship are the Basis for Collaborative Care
This again is obvious and need not be proved (although there is a huge amount of research data proving this as an empirical fact).
1.7 Individualized and Person-Centered Health Care for Chronic Diseases (ISM)
Medical care has improved enormously in the last century. The life expectancy of today's generations has been increased significantly. Where, however, addictive patterns and very change-resisting behavior patterns are prevalent, the classical care situation with a short contact between patient and doctor reaches its limits.
This is true for all chronic diseases. So there is a need for the patients with chronic diseases to receive “treatment support” or even “adaptation and behavior modification support”.
1.8 Lifelong Support for Chronical Disease Patients is Necessary (“Individualized Support Management”=ISM)
All the existing research has shown that patients with chronic diseases need support and there are altogether four sources:                (1) the person himself/herself (self-motivation, internet contacts, health care education, training etc.);        (2) the direct social environment (support by partner, family, and friends);        (3) the “second” social environment and groups (like patient support groups, training groups, and self-care groups);        (4) the medical support by doctors and health care practitioners (as the last—and financially most expensive and also limited—resource).2. The Corresponding Challenges and Solutions for the Existing Problems2.1 “Standardized” Treatment        
The “Health Care Repair Systems” of today (with the “rushed doctor in a fragmented system”) are disease-focused with patients as (more or less) an “object” of a (more or less) standardized treatment.
2.2 “Separation” from the Own Health
The modern patients are more or less “separated” from or “alienated” by their own health; only very few (less than 10% of the population) are really fully empowered and “in charge of their individual health management”.
2.3 Need for Help
Both, patients and doctors, need help.
Let us take the example of the US American society: More than 50% of the doctors suffer from burnout syndrome and doctors starting show the normal depression rate of the population (4%) which increases after one year up to striking 25%.
Let us take the following examples of diabetes care: Only 7% of the US patients reach the three objectives which are relevant to preserve their lives: reaching the blood pressure goals, reaching the objectives for lipids/cholesterol, and reaching the average level HbA1c for blood sugar, avoiding extreme hypoglycemic and hyperglycemic states.
2.4 Standardized Vs. Individualized Treatment of Diabetes Type 2 Patients
All diabetes type 2 patients are certainly checked in terms of bio-medical status (level 1). This is, however, only the “Peak of the Iceberg” (see Annex I).
2.5 Treatment of the Patient as an “Object” in a “Standardized Procedure”
If the patient is treated as an “object” in a “standardized treatment procedure”, the results are inferior (especially in person- and psychology-related chronic diseases).